Naegleria fowleri (Primary amebic meningoencephalitis)

Summary of Naegleria fowleri (Primary amebic meningoencephalitis)
Naegleria fowleri is an amoeba that can be pathogenic, causing a fulminant brain infection known as primary amoebic meningoencephalitis. This microorganism is typically found in bodies of warm freshwater, such as ponds, lakes, rivers, and hot springs, and may gain access to the central nervous system through the cribriform plate. Amoebas can be seen on spinal fluid analysis. Amphotericin B, though not typically effective, is the treatment of choice.

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Naegleria fowleri (Primary amebic meningoencephalitis)

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Naegleria fowleri (Primary amebic meningoencephalitis)

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Diagnosis of Naegleria fowleri is via visualization of in spinal fluid.

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A 23-year-old woman is brought to the emergency department by her mother due to rapid deterioration over the past two days. She initially had a high fever but has now developed seizures, hallucinations, and is profusely vomiting. Her medical history is noncontributory, and examination shows a loss of coordination and a stiff neck. She is a diver and has been swimming in a nearby lake in the past week. A lumbar puncture is performed and shows amoebas in her cerebrospinal fluid. Which of the following is the most appropriate pharmacotherapy for this patient?

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